How much rates vary
Facilitymedian $617 · 10th to 90th $123 to $4,365Professionalmedian $309 · 10th to 90th $219 to $468
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $269.15 Median $2,137.96 Typical High $10,715.19 | Facility | None | $269.15 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $338.84 | Professional | None | $269.15 | $309.03 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $512.86 | Professional | None | $275.42 | $316.23 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $154.88 Typical High $245.47 | Facility | None | $134.90 | $154.88 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $457.09 | Professional | None | $223.87 | $263.03 | $457.09 |
Hometown Health Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $512.86 | Professional | None | $190.55 | $309.03 | $512.86 |
Hometown Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $0.72 Median $213.80 Typical High $562.34 | Professional | None | $0.72 | $213.80 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $4,265.80 | Facility | None | $295.12 | $380.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $588.84 | Professional | None | $234.42 | $338.84 | $588.84 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $489.78 | Professional | None | $186.21 | $302.00 | $489.78 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $151.36 Typical High $165.96 | Professional | 52 · Reduced service | $134.90 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $199.53 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $45.71 Typical High $50.12 | Professional | 55 · Aftercare only | $39.81 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.92 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $186.21 | $213.80 | $229.09 |
Where Nevada sits
The same service costs 6.7 times more in New York than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
NY $2,828FL $419
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.